NATURE 



605 



THURSDAY, JULY 15, 1920. 



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Medical Research. 



'' A TEACHING hospital will not be content 



r\^ solely with making- the best possible pro- 

 vision for the treatment of injury and disease and 

 for imparting knowledge ; it will recognise as one 

 of its most important functions also the increase 

 of knowledge. 



"The problems of disease presented by living 

 patients are the most difficult and complex in the 

 whole range of the physical and natural sciences. 

 Much light can be shed on them by investigations 

 conducted in physiological, chemical, pathological, 

 pharmacological, and bacteriological laboratories, 

 especially by experimentation on animals ; but it is 

 increasingly clear that the scientific study of many 

 of these problems can be undertaken with the 

 greatest advantage in well-equipped, special labo- 

 ratories connected with the hospital clinics and 

 in charge of investigators trained in chemical, 

 physical, and biological methods, with convenient 

 access to the material for study and in close touch 

 with the clinicians. 



"The familiar analytical and statistical study of 

 cases of disease, based on simple clinical observa- 

 tions, and first extensively and fruitfully applied 

 by the great French clinicians of the early part of 

 the last century, has been of immense service to 

 medicine, and will continue to be of service. A 

 good clinical observation has precisely the same 

 scientific value as a fact demonstrated in the labo- 

 ratory, and, even if more difficult of interpreta- 

 tion, is often the safer guide for the action of the 

 physician. 



" It is, however, from the special clinical labora- 

 tories that we may reasonably hope for a more 

 penetrating insight into the causes and nature of 

 many diseases, an insight which perhaps may arm 

 physicians with a saving power of prevention and 

 treatment of some of the organic diseases of ad- 

 vancing life comparable to the inestimable gifts 

 of bacteriological laboratories to the prevention 

 and treatment of infectious diseases. We must 

 welcome the establishment of such laboratories 

 and the new directions which they are giving to 

 medical research. When the purposes of such 

 laboratories are made clear, their foundation and 

 NO. 2646, VOL. 105] 



support should make an especially strong appeal 

 to public and private philanthropy." 



I have quoted these remarks made some thir- 

 teen years ago by the distinguished leader of 

 American medicine. Prof. William H. Welch, of 

 the Johns Hopkins University, because they ex- 

 press so precisely the motive and the object of 

 the reforms to be effected at the University 

 College Hospital Medical School with the help of 

 the Rockefeller gift. Dr. Welch spoke not only 

 with deep insight and eloquence, but also with 

 the experience he had gained as the Father of the 

 Johns Hopkins Hospital and its famous Medical 

 School. 



The aim of the reforms of medical education 

 that were introduced at the Johns Hopkins Uni- 

 versity in 1893 was primarily to educate the 

 medical student rather than' merely to prepare 

 him for examinations. In other words, every en- 

 couragement was given him to learn by personal 

 observation and experiment and to rely upon his 

 own judgment ; and he was provided with every 

 facility in the way of properly equipped labora- 

 tories and ample material to carry out this scheme 

 of work. Above all, he was given the time, un- 

 disturbed by multitudes of didactic classes, in 

 which to cultivate his powers of observation and 

 acquire knowledge by his own efforts. In other 

 words, the ideal was to make every student and 

 member of the staff devote himself to original 

 research and the advancement of knowledge. 

 How fruitful such a method can become we know 

 from the history of our schools of physiology. 

 The influence of the great reforms introduced at 

 University College by Prof. Sharpey eighty years 

 ago was carried to Cambridge by Sir Michael 

 Foster, to Oxford by Sir J. Burdon Sanderson, 

 and to the Johns Hopkins University by Prof. 

 Newell Martin ; and the result of these practical 

 methods of studying physiology has been to con- 

 vert almost every department of that subject into 

 an institute of research and a perennial source of 

 new knowledge. 



The contrast presented by departments of 

 anatomy in the English-speaking world, before 

 1893 in America, but even now in this country, is 

 profound. The remarkable activity of physiology 

 has been one of the contributory causes ; and the 

 very circumstance that Sharpey, the reformer of 

 physiological education, was primarily a professor 

 of anatomy was one of the factors in sterilising 

 the spirit of adventure in his own subject. This 

 paradoxical result was due to the fact that as a 

 professor of anatomy and physiology Sharpey was 



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